Creating a Practice-Based Implementation Network: Facilitating Practice Change Across Health Care Systems

• DOI: 10.1007/s11414-020-09696-3
• Publication Date: 2020-05-03T20:02:16Z
• Authors: Josef I. Ruzek; Sara J. Landes; Pearl McGee-Vincent; Craig S. Rosen; Jill Crowley; Patrick S. Calhoun; Kate McGraw; Robyn D. Walser; Jeffrey L. Smith; David S. Barry; Janet Schmidt; Erica Simon; Jennifer Runnals; Nancy H. Liu; R. Keith Shaw; Lindsey Zimmerman; Danny Nottis; Quyen Q. Tiet; Katherine M. Juhasz; JoAnn E. Kirchner
• Keywords: Mental Health Services; Primary Health Care; Hospitals, Veterans; Health Personnel; Mental Disorders; 05 social sciences; Proof of Concept Study; United States; Checklist; 3. Good health; Stress Disorders, Post-Traumatic; United States Department of Veterans Affairs; 03 medical and health sciences; Mental Health; 0302 clinical medicine; Evidence-Based Practice; Humans; Mass Screening; 0501 psychology and cognitive sciences; Delivery of Health Care; Goals; Program Evaluation; Veterans

A proof-of-concept practice-based implementation network was developed in the US Departments of Veteran Affairs (VA) and Defense to increase the speed of implementation of mental health practices, derive lessons learned prior to larger-scale implementation, and facilitate organizational learning. One hundred thirty-four clinicians in 18 VA clinics received brief training in the use of the PTSD checklist (PCL) in clinical care. Two implementation strategies, external facilitation and technical assistance, were used to encourage the use of outcomes data to inform treatment decisions and increase discussion of results with patients. There were mixed results for changes in the frequency of PCL administration, but consistent increases in clinician use of data and incorporation into the treatment process via discussion. Programs and clinicians were successfully recruited to participate in a 2-year initiative, suggesting the feasibility of using this organizational structure to facilitate the implementation of new practices in treatment systems.